{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:00:13Z","timestamp":1777532413508,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100016270","name":"Global Challenges Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006388","name":"Geneva University Hospitals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006388","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2026,1,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic respiratory disease burden in Nepal is high, although data from the Terai (lowlands) is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Through a community outreach programme in Mechinagar, 3398 adults (mean age 49.6\u00a0years, 59% female) were recruited to complete spirometry and questionnaires to determine prevalences of airflow obstruction, breathlessness (MRC dyspnoea score \u22653) and self-reported chronic lung disease. Multivariate logistic regression examined associated demographic and lifestyle factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prevalences of airflow obstruction (15%) and breathlessness (13%) exceeded self-reported chronic lung disease (8%). Age (odds ratio = 1.06, 95% confidence interval = 1.05-1.07), body mass index (BMI) per 1\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (0.90, 0.88-0.93), physical inactivity (1.95, 1.07-3.84) and no formal education (1.46, 1.14-1.88) were associated with airflow obstruction. Smoking was only associated with airflow obstruction in females (1.90, 1.22-2.94) and adults \u226540 years (1.40, 1.05-1.86). Age (1.04, 1.03-1.05), airflow obstruction (2.43, 1.85-3.18), and male sex (0.63, 0.49-0.80) were associated with breathlessness. Only in females was breathlessness associated with BMI (1.08, 1.05-1.12) and mixed biomass use (2.65, 1.39-4.85). In men, labour\/farming\/agriculture work (3.30, 1.12-14.20) or unemployment (4.39, 1.43-19.30) was associated with breathlessness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is likely underdiagnosis of chronic lung disease in the Terai. Addressing smoking, educational disparities, physical inactivity and environmental pollutant exposure are public health priorities to improve respiratory health in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14799731251415399","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T15:46:17Z","timestamp":1768578377000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Lung health in the Terai region of Nepal"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5523-5435","authenticated-orcid":false,"given":"Malik","family":"Hamrouni","sequence":"first","affiliation":[{"name":"University of Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8392-8028","authenticated-orcid":false,"given":"Sanjib K","family":"Sharma","sequence":"additional","affiliation":[{"name":"BP Koirala Institute of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9518-4716","authenticated-orcid":false,"given":"Om P","family":"Kurmi","sequence":"additional","affiliation":[{"name":"Coventry University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3650-1604","authenticated-orcid":false,"given":"Prajwal","family":"Gautam","sequence":"additional","affiliation":[{"name":"BP Koirala Institute of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suman","family":"Lohani","sequence":"additional","affiliation":[{"name":"Chitwan Medical College and Teaching Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-1524","authenticated-orcid":false,"given":"Ujwal","family":"Gautam","sequence":"additional","affiliation":[{"name":"BP Koirala Institute of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigiriya A","family":"Perone","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals"},{"name":"Health Unit of the International Committee of the Red Cross"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Heller","sequence":"additional","affiliation":[{"name":"Geneva University Hospitals"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian P","family":"Hall","sequence":"additional","affiliation":[{"name":"University of Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tricia M","family":"McKeever","sequence":"additional","affiliation":[{"name":"University of Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-2249","authenticated-orcid":false,"given":"Charlotte E","family":"Bolton","sequence":"additional","affiliation":[{"name":"University of Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00458-X"},{"key":"e_1_3_5_3_2","unstructured":"World Health Organisation. Chronic obstructive pulmonary disease (COPD). https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd) (accessed 18 February 2025)."},{"key":"e_1_3_5_4_2","unstructured":"Momtazmanesh S Moghaddam SS Ghamari S-H et al. Global burden of chronic respiratory diseases and risk factors 1990\u20132019: an update from the global burden of disease study 2019. eClinicalMedicine; 59. Epub ahead of print 1 May 2023."},{"key":"e_1_3_5_5_2","unstructured":"World Health Organisation. Noncommunicable diseases Nepal 2018 country profile. https:\/\/www.who.int\/publications\/m\/item\/noncommunicable-diseases-npl-country-profile-2018 accessed 18 February 2025."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1479973121994572"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.33314\/jnhrc.v19i04.3543"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-069X-13-92"},{"key":"e_1_3_5_9_2","doi-asserted-by":"crossref","unstructured":"Kumari P Poudel L Chaudhary L et al. Prevalence and associated factors of respiratory symptoms and illnesses among brick kiln workers in Nepal \u2014A cross-sectional study. Environmental and Occupational Health Practice; 6. Epub ahead of print 2024.","DOI":"10.1539\/eohp.2024-0003-OA"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.3126\/nje.v6i1.14733"},{"key":"e_1_3_5_11_2","volume-title":"Noncommunicable disease risk factors: STEPS survey Nepal 2019","unstructured":"Noncommunicable disease risk factors: STEPS survey Nepal 2019. Nepal Health Research Council. https:\/\/nhrc.gov.np\/publication\/noncommunicable-disease-risk-factors-steps-survey-nepal-2019\/ (accessed 20 February 2025)."},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S268110"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.23065"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2023.115669"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","unstructured":"Stanojevic S Kaminsky DA Miller MR et al. ERS\/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J; 60. DOI: 10.1183\/13993003.01499-2021 Epub ahead of print 13 July 2022.","DOI":"10.1183\/13993003.01499-2021"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02962-2021"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0218PP"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5213.1665"},{"key":"e_1_3_5_20_2","unstructured":"UKRI. Respiratory questionnaire and instructions to interviewers (1986). https:\/\/www.ukri.org\/publications\/respiratory-questionnaire-and-instructions-to-interviewers-1986\/ 2016 accessed 16 May 2025."},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00102509"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.39.5.331"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-006786"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2013.09.011"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200704-553CC"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.22158\/rhs.v5n1p48"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00111608"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6512-z"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihz008"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237769"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1179\/oeh.2005.11.2.150"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00220511"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihaa055"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/ce\/zkaa022"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12908"}],"container-title":["Chronic Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14799731251415399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14799731251415399","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14799731251415399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:48:32Z","timestamp":1777394912000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14799731251415399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":34,"alternative-id":["10.1177\/14799731251415399"],"URL":"https:\/\/doi.org\/10.1177\/14799731251415399","relation":{},"ISSN":["1479-9731","1479-9731"],"issn-type":[{"value":"1479-9731","type":"print"},{"value":"1479-9731","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]},"article-number":"14799731251415399"}}